青岛市4～6岁儿童中远立体视觉调查结果

Analysis of Middle-Far Stereoaeuity among Children Aged 4 to 6 Years Old in Qingdao

目的：探讨中远立体视图作为学龄前儿童异常视功能筛查的辅助工具的可行性。方法：横断面调查研究。在2016 年6 月1－30 日期间采取随机抽样的方法抽取青岛市市南区、市北区、李沧区、崂山区的幼儿园4～6 岁儿童850 人，采用Lea numbers视力表测量视力，使用中远立体视图检查中远立体视觉，应用遮盖去遮盖及交替遮盖的方法检查斜视情况。数据的比较采用Kruskal-Wallis H秩和检验和列联表检验。结果：除外斜视及视力异常的儿童，正常受检儿童762人，中远立体视觉60？ 583人（76.5%），100？ 29 人（3.8%），400？ 10 人（1.3%），无立体视觉140 人（18.4%）。4 岁组、5 岁组和6 岁组间有60？、100？、400？立体视觉者，无立体视觉者各组所占比例的差异有统计学意义（χ2=355.67，P＜0.001）；随着年龄的增加，能辨认出60？的人数比例在增加；经过两两比较，4 岁组和5 岁组（χ2=173.23，P＜0.001），5岁组和6岁组（χ2=278.23，P＜0.001），4岁组和6岁组（χ2=150.68，P＜0.001），组间差异均有统计学意义。正常组和非正常组有60？、100？、400？立体视觉者，无立体视觉者所占比例的差异有统计学意义（χ2=58.50，P＜0.001）。结论：立体视觉随着年龄的增长有逐步发育的倾向。对于视力指认困难的学龄前儿童，中远立体视图可以作为筛查视觉功能异常的一种辅助手段。

Objective： To determine if the Distance Randont Stereotest can assist anomaly screening of visual function in young children. Methods： In this cross-sectional investigation, children （n=850） aged 4-6 years old were selected by cluster sampling from the kindergartens in the districts of Shinan, Shibei, Licang, and Laoshan from June 1 to 30, 2016. Visual acuity was tested by Lea numbers （GOOD-LITE） chart, and middle-far stereoacuity was examined by the Distance Randot Stereotest Picture. Strabismus was excluded by the cover-uncover test. Data were analyzed by kruskal-wallis H rank-sum test and crosstabs. Results： There were 762 normal children without strabismus and visual acuity problems. Among these, 583（76.5%） had 60 arcsec stereoacuity, 29（3.8%） had 100 arcsec, 10（1.3%） had 400 arcsec, and 140 （18.4%） had none. Based on kruskal-wallis H testing, the frequency of children with 60 arcsec, 100 arcsec, 400 arcsec and non-steroacuity had distinguished difference among the different ages （χ2=355.67, P〈0.001）. The ratio of the children who could figure out the 60 arcsec increased with age. There was a significant difference between the 4-year-olds and the 5-year-olds （χ2=173.23, P〈0.001）, the 5-year-olds and the 6-year-olds （χ2=278.23, P〈0.001）, the 4-year-olds and the 6-year-olds （χ2=150.68, P〈0.001）. Similarly, compared with the non-normal group, the normal group had significantly better stereoacuity （χ2=58.50, P〈0.001） according to the crosstabs testing. Conclusions： Stereoacuity developed with increasing age. For the preschool children who could not understand the visual chart, and the Distance Randot Stereotest Picture may be helpful to screen for visual function anomalies.